Potential health consequences of recession

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The Bureau of Labor Statistics just announced a jump in the jobless rate, from 6.8 percent in November to 7.2 percent in December.

This indicates that there is further growth in the ranks of the uninsured. As many as half a million people may lose their health coverage as a result of last month’s job losses.

A new report by The George Washington University School of Public Health and Health Services (GW/SPHHS) spells out the potential health consequences of this, and other aspects of the recession. It also reviews proposals that are part of federal efforts to stimulate an economic recovery, and that would help to reduce impoverishment, strengthen access to health care, and protect the health of more Americans.

The links between income and health are clear - higher-income people live longer, with less disease and disability, than lower-income people. Research also shows that:

In recent months a rising number of Americans have failed to obtain medical care because of its cost, cut back on preventive care, and skimped on their medication.

For every one percent rise in joblessness more than one million people join the ranks of the uninsured. People who are uninsured receive poorer medical care, are less likely to get recommended screenings and other prevention services, and are more likely to delay physician visits, neglect chronic conditions, and incur medical debt.

When joblessness jumps by one percent, states add about one million more people to the rolls of Medicaid and the State Children’s Insurance Program (SCHIP), putting increased pressure on their already tight budgets. Many states are cutting their Medicaid programs despite evidence that it is an economic, efficient, and resilient form of health insurance coverage.

Families are being forced to choose among competing demands for food, home energy, and health care. Families that are “food insecure” or “energy insecure” are more likely to have children in poorer health.

The most effective economic recovery package will increase protections to vulnerable families and put money into the hands of people most likely to spend it quickly. Policymakers are considering:

Increasing federal contributions to state Medicaid programs to assure that states maintain their eligibility levels.

Expanding SCHIP to reach more children.

Increasing benefits through the Supplemental Nutritional Assistance Program (formerly called the Food Stamp Program). This program serves as the link between food insecurity and health and is an important engine of economic growth.

Expanding home energy assistance. The federal Low Income Home Energy Assistance Program reaches only about 16 percent of eligible families, despite its demonstrated benefits to child health.

Extending unemployment insurance. The incoming Director of the Office of Management and Budget calls unemployment insurance one of the most effective economic stabilizers available to counter economic weakness.

Providing health insurance temporarily for recently laid-off workers and their families. One approach is to underwrite the costs of COBRA health insurance coverage, which is currently available to people who have lost their jobs only if they were previously covered and can afford the premiums. Another strategy is to widen Medicaid coverage to those who are not currently poor enough to qualify, but still can not afford health insurance on their own.

Targeting individuals and families suffering from the consequences of the downturn, and helping to stabilize and revitalize their communities may begin to reverse the health consequences of the recession.

The GW/SPHHS report — “Examining the Health Consequences of the 2008-09 Recession” can be downloaded at: http://www.gwumc.edu/sphhs/about/rapidresponse/index.cfm.

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